• 1

    Desjeux P, 1992. Human leishmaniases: epidemiology and public health aspects. World Health Stat Q 45 :267–275.

  • 2

    Marsden PD, 1986. Mucosal leishmaniasis (“espundia” Escomel, 1911). Trans R Soc Trop Med Hyg 80 :859–876.

  • 3

    Alcais A, Abel L, David C, Torrez ME, Flandre P, Dedet JP, 1997. Evidence for a major gene controlling susceptibility to tegumentary leishmaniasis in a recently exposed Bolivian population. Am J Hum Genet 61 :968–979.

    • Search Google Scholar
    • Export Citation
  • 4

    Ribeiro-de-Jesus A, Almeida RP, Lessa H, Bacellar O, Carvalho EM, 1998. Cytokine profile and pathology in human leishmaniasis. Braz J Med Biol Res 31 :143–148.

    • Search Google Scholar
    • Export Citation
  • 5

    Cabrera M, Shaw MA, Sharples C, Williams H, Castes M, Convit J, Blackwell JM, 1995. Polymorphism in tumor necrosis factor genes associated with mucocutaneous leishmaniasis. J Exp Med 182 :1259–1264.

    • Search Google Scholar
    • Export Citation
  • 6

    Jeronimo SM, Teixeira MJ, Sousa A, Thielking P, Pearson RD, Evans TG, 2000. Natural history of Leishmania (Leishmania) chagasi infection in Northeastern Brazil: long-term follow-up. Clin Infect Dis 30 :608–609.

    • Search Google Scholar
    • Export Citation
  • 7

    Blackwell JM, Black GF, Peacock CS, Miller EN, Sibthorpe D, Gnananandha D, Shaw JJ, Silveira F, Lins-Lainson Z, Ramos F, Collins A, Shaw MA, 1997. Immunogenetics of leishmanial and mycobacterial infections: the Belem Family Study. Philos Trans R Soc London B Biol Sci 352 :1331–1345.

    • Search Google Scholar
    • Export Citation
  • 8

    Bacellar O, Lessa H, Schriefer A, Machado P, Ribeiro de Jesus A, Dutra WO, Gollob KJ, Carvalho EM, 2002. Up-regulation of Th1-type responses in mucosal leishmaniasis patients. Infect Immun 70 :6734–6740.

    • Search Google Scholar
    • Export Citation
  • 9

    Grimaldi G Jr, Tesh RB, McMahon-Pratt D, 1989. A review of the geographic distribution and epidemiology of leishmaniasis in the New World. Am J Trop Med Hyg 41 :687–725.

    • Search Google Scholar
    • Export Citation
  • 10

    Belkaid Y, Piccirillo CA, Mendez S, Shevach EM, Sacks DL, 2002. CD4+CD25+ regulatory T cells control Leishmania major persistence and immunity. Nature 420 :502–507.

    • Search Google Scholar
    • Export Citation
  • 11

    Sacks D, Noben-Trauth N, 2002. The immunology of susceptibility and resistance to Leishmania major in mice. Nat Rev Immunol 2 :845–858.

  • 12

    Grimaldi G Jr, Tesh RB, 1993. Leishmaniases of the New World: current concepts and implications for future research. Clin Microbiol Rev 6 :230–250.

    • Search Google Scholar
    • Export Citation
  • 13

    Gillespie RD, Mbow ML, Titus RG, 2000. The immunomodulatory factors of bloodfeeding arthropod saliva. Parasite Immunol 22 :319–331.

  • 14

    Bretscher PA, Ogunremi O, Menon JN, 1997. Distinct immunological states in murine cutaneous leishmaniasis by immunising with different amounts of antigen: the generation of beneficial, potentially harmful, harmful and potentially extremely harmful states. Behring Inst Mitt 98 :153–159.

    • Search Google Scholar
    • Export Citation
  • 15

    Dye C, 1992. Leishmaniasis epidemiology: the theory catches up. Parasitology 104 (Suppl):S7–18.

  • 16

    Almeida RP, Barral-Netto M, De Jesus AM, De Freitas LA, Carvalho EM, Barral A, 1996. Biological behavior of Leishmania amazonensis isolated from humans with cutaneous, mucosal, or visceral leishmaniasis in BALB/C mice. Am J Trop Med Hyg 54 :178–184.

    • Search Google Scholar
    • Export Citation
  • 17

    Cupolillo E, Grimaldi G Jr, Momen H, 1997. Genetic diversity among Leishmania (Viannia) parasites. Ann Trop Med Parasitol 91 :617–626.

  • 18

    Schriefer A, Schriefer AL, Goes-Neto A, Guimaraes LH, Carvalho LP, Almeida RP, Machado PR, Lessa HA, de Jesus AR, Riley LW, Carvalho EM, 2004. Multiclonal Leishmania braziliensis population structure and its clinical implication in a region of endemicity for American tegumentary leishmaniasis. Infect Immun 72 :508–514.

    • Search Google Scholar
    • Export Citation
  • 19

    Coffman RL, Beebe AM, 1998. Genetic control of the T cell response to Leishmania major infection. Adv Exp Med Biol 452 :61–66.

  • 20

    Saravia NG, Valderrama L, Labrada M, Holguin AF, Navas C, Palma G, Weigle KA, 1989. The relationship of Leishmania braziliensis subspecies and immune response to disease expression in New World leishmaniasis. J Infect Dis 159 :725–735.

    • Search Google Scholar
    • Export Citation
  • 21

    Conceicao-Silva F, Dorea RC, Pirmez C, Schubach A, Coutinho SG, 1990. Quantitative study of Leishmania braziliensis braziliensis reactive T cells in peripheral blood and in the lesions of patients with American mucocutaneous leishmaniasis. Clin Exp Immunol 79 :221–226.

    • Search Google Scholar
    • Export Citation
  • 22

    Belkaid Y, 2003. The role of CD4(+)CD25(+) regulatory T cells in Leishmania infection. Expert Opin Biol Ther 3 :875–885.

  • 23

    Karplus TM, Jeronimo SM, Chang H, Helms BK, Burns TL, Murray JC, Mitchell AA, Pugh EW, Braz RF, Bezerra FL, Wilson ME, 2002. Association between the tumor necrosis factor locus and the clinical outcome of Leishmania chagasi infection. Infect Immun 70 :6919–6925.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

FAMILIAL AGGREGATION OF MUCOSAL LEISHMANIASIS IN NORTHEAST BRAZIL

View More View Less
  • 1 Serviço de Imunologia Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador-Bahia, Brazil; Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador-Bahia, Brazil; Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, New York, New York; Departments of Internal Medicine and Microbiology, University of Iowa, Iowa City, Iowa

To evaluate whether familial clustering occurs in mucosal leishmaniasis (ML), patients with ML (index cases) were randomly selected from medical records at a health post in an endemic area for Leishmania braziliensis infection. Control individuals (index controls) matched by age, gender, and place of residence to index cases were selected. Family members of index cases and controls were compared with respect to environmental factors and the incidence of cutaneous leishmaniasis (CL) and ML. Delayed type hypersensitivity test (DTH) to Leishmania antigen was tested in selected families. Among 289 members of 46 families enrolled, significant differences were found in the frequencies of CL (37% versus 20%) and ML (5% versus 0) in case versus control families, respectively. Families with 2 cases of ML had a higher frequency (29.6%) of DTH-positive individuals than control families (9.4%). These data demonstrate familial clustering of CL, ML, and positive DTH skin tests in an area endemic for L. braziliensis infection.

Author Notes

Reprint requests: Amelia Ribeiro de Jesus, Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, 5° Andar, Rua João das Botas s/n, Canela, CEP 40110-160, Salvador-Bahia, Brazil, Telephone: 71-237-7353, Fax: 71-245-7110, E-mail: imuno@ufba.br or amelia@ufba.br.
Save